Apr 22, 2011

FOIA Friday: The NIH Reacts to "Show Me the Money!" Researcher

By Paul Thacker

This week’s document: A letter sent to Emory University expressing concerns about the conflicts of interest and “independence and objectivity” of Dr. Zachary Stowe, Professor of Psychiatry & Behavioral Sciences and Director of the Women’s Mental Health Program at Emory University School of Medicine.

Agency: National Institutes of Health (NIH).

Context: The NIH sent Emory this letter in July 2009 after the media exposed Dr. Zachary Stowe’s cozy financial relationship with GlaxoSmithKline (GSK) while also receiving NIH grants to study antidepressants like GSK’s Paxil in pregnant women.

Language here is important.

The NIH initially discusses Dr. Stowe’s “conflicts” as perceived, which is how this matter is normally expressed. Whenever talking about financial conflicts of interest, government officials regularly soften their language with descriptors like “apparent,” “potential,” or “possible.” In reality, these words complicate the obvious: academic physicians are being bought off by corporations.

So it’s a little interesting to see these squishy adjectives chucked aside for sharp-elbowed rhetoric in some passages. At one point, the letter reads, “We are specifically concerned about Dr. Stowe’s independence and objectivity….”

The NIH concludes:

Consequently, we believe that any renewed relationships with antidepressant manufacturers might greatly diminish the apparent independence and objectivity of the data evaluation and reporting of the research results supported by this Center grant, and thus we are requesting further clarification on Emory’s plans with respect to this matter.

Pretty tough language for the NIH. But what could have prodded the agency?

BACKGROUND

In the month prior, The Wall Street Journalexposed Dr. Stowe’s lucrative marketing talks for GSK. In 2007, the company paid him $154,400 and $99,300 during the first 10 months of 2008 to give talks to other physicians, selling them on Paxil. Since 2003, Stowe was listed as the primary investigator on at least three NIH grants studying antidepressants in pregnant women and the effects on children delivered by those women.

Senator Charles Grassley (R-IA) revealed the payments in a letter he sent to the NIH while investigating conflicts of interest in academic medicine. The senator also attached some emails in which Dr. Stowe had a heated exchange with GSK representatives when they cancelled two promotional talks that he was scheduled to deliver.

Caution to readers: When someone warns you in an email that they “do not want to be a prick,” they are probably being…a prick.

From the emails:

GSK Rep: I am sincerely sorry, but we will are going to have to cancel both programs scheduled for this Wed and Thur. in Wisconsin.

Dr. Stowe: What provisions do you propose for my compensation and lost time?

GSK Rep: (no response)

Dr. Stowe: I am willing to discuss modification of my compensation for the lost days e.g. renumeration for a single talk ($2,500) rather than the two scheduled.

GSK Rep: (no response)

Dr. Stowe: I have sent you 3 emails regarding the cancelled programs, and have yet to receive a reply….Simply you owe me a minimum of 2,500 for the first talk and 2,000 (since a spearate [sic] day should actually be 2,500) for the second talk, so you are still getting a $500 discount. This is a total of $4,500 that should be mailed asap.

GSK Rep: (no response)

Dr. Stowe to another GSK Rep: I do not want to be a prick, but given the time and frustration, I think she should arrange to pay me for both the talks as noted in my last email to her.

For failing to disclose his relationship with GSK, Emory officially reprimanded Dr. Stowe.

What remains uncertain is if these lucrative talks had any influence on Dr. Stowe’s research and advice to doctors and patients. What is abundantly clear from the public record is that Dr. Stowe is a big proponent of pregnant women taking antidepressants. Antidepressants like GSK’s Paxil.